Developed hyponatremia during hysteroscopic myomectomy - A case report -

Kim, Hwan Hee; Hwang, Jin Young; Jeon, Young Tae; Hwang, Jung Won; Hwan, Sang; Na, Hyo Seok

doi:10.4097/kjae.2009.57.5.629

Cited by 2 publications

(5 citation statements)

References 14 publications

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“…General anesthesia could mask early signs of hyponatremia and water intoxication such as bradycardia, hypertension, headache, nausea, and mental status change. [2,8] In our patient, who had general anesthesia, we did not detect water intoxication and hyponatremia until cerebral edema developed, which presented with seizures. Hyponatremia is associated with convulsions and coma.…”

Section: Discussionmentioning

confidence: 59%

Cerebral Edema Associated with Hyponatremia after Hysteroscopic Myomectomy

Uyar¹

2022

Lokman Hekim Health Sci

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The hypotonic fluid used for distention of the uterus during hysteroscopic myomectomy creates hyponatremia and hypervolemia with resulting cerebral edema. This situation is called operative hysteroscopy ıntravascular absorption syndrome. A 33-year-old woman was admitted for elective hysteroscopic myomectomy with general anesthesia. Sorbitol/mannitol solution was used as a distending solution for surgical hysteroscopy. The patient did not wake up after the operation and generalized seizures had been started. Hyponatremia was detected in her blood tests and started to be corrected rapidly with hypertonic saline. Brain edema was considered in her cranial magnetic resonance imaging. The patient was completely recovered after the treatment. This case is the case of brain edema caused by hyponatremia occurring after hysteroscopic surgery. It was presented with rarely reported symptoms such as seizures and psychosis, which resulted in a good prognosis. A case of acute cerebral edema progressing in this way has been rarely reported in the literature.

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Section: Discussionmentioning

confidence: 59%

Cerebral Edema Associated with Hyponatremia after Hysteroscopic Myomectomy

Uyar¹

2022

Lokman Hekim Health Sci

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“…Hysteroscopic procedures have been increasingly used with several benefits when compared with traditional surgical procedures. Despite their increasing use, the absorption of fluid distention media can still cause unpredictable complications such as volume overload, dilutional hyponatremia, water intoxication, and cerebral edema [ 1 - 3 ]. Generally, serum sodium levels decrease by 10 mmol/L for every liter of hypotonic fluid absorption [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study of 101 patients who absorbed over 2 L of glycin solution during myoma resections, the patients did not develop volume overload, and their recovery was usually uneventful within 12 hours [ 5 ]. However, absorption of less than 2 L of distention medium could cause death induced by hyponatremia (98 mmol/L) and cerebral edema [ 3 ]. In our case, the patient experienced extreme hyponatremia (83 mmol/L) accompanied by metabolic acidosis due to absorption of the distention medium, resulting in pulmonary edema and brain swelling, with absorption of less than 2 L of distention fluid.…”

Section: Discussionmentioning

confidence: 99%

“…In previous cases, respiratory acidosis induced by hypercarbia was accompanied by pulmonary edema [ 2 , 3 ]. Hypercarbia may induce peripheral arteriolar dilatation and lead to the increased absorption of fluid distention medium.…”

Section: Discussionmentioning

confidence: 99%

“…These side effects can also lead to death [ 2 ]. Although there have been reports of dilutional hyponatremia following hysteroscopy [ 1 - 3 ], there have been no cases presenting severe hyponatremia of less than 90 mmol/L accompanied by metabolic acidosis. We report on a patient with an extreme hyponatremia caused by using an electrolyte-free 5 : 1 sorbitol/mannitol solution as a distention medium for hysteroscopic myomectomy.…”

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confidence: 99%

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Extreme hyponatremia with moderate metabolic acidosis during hysteroscopic myomectomy -A case report-

Jeon

Choi

et al. 2011

Korean J Anesthesiol

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Excess absorption of fluid distention media remains an unpredictable complication of operative hysteroscopy and may lead to lethal conditions. We report an extreme hyponatremia, caused by using an electrolyte-free 5 : 1 sorbitol/mannitol solution as distention/irrigation fluid for hysteroscopic myomectomy. A 34-year-old female developed severe pulmonary edema and extreme hyponatremia (83 mmol/L) during transcervical endoscopic myomectomy. A brain computed tomography showed mild brain swelling without pontine myelinolysis. The patient almost fully recovered in two days. Meticulous attention should be paid to intraoperative massive absorption of fluid distention media, even during a simple hysteroscopic procedure.

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Developed hyponatremia during hysteroscopic myomectomy - A case report -

Cited by 2 publications

References 14 publications

Cerebral Edema Associated with Hyponatremia after Hysteroscopic Myomectomy

Cerebral Edema Associated with Hyponatremia after Hysteroscopic Myomectomy

Extreme hyponatremia with moderate metabolic acidosis during hysteroscopic myomectomy -A case report-

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